Sex and risk among people in their 20s

High rates of unintended pregnancy and sexually transmitted infections are reported.

May 03, 2010|By Jessica Pauline Ogilvie, Special to the Los Angeles Times

No amount of magical thinking will negate the fact that ambivalence about… (Michael Tullberg / Getty…)

Over the last few decades, the period between the time when young adults leave their parents' house and when they settle down to start families has grown substantially. In 1970, 21% of 25-year-olds were unmarried; by 2005, the percentage had jumped to 60%.

Marked by self-discovery and exploration, this phase of life has been dubbed the "odyssey years" by some. And along with determining their career and life goals, many unmarried adults in their 20s are also trying to figure out how to manage their sex lives.

According to a poll published earlier this year by the National Campaign to Prevent Teen and Unplanned Pregnancy, 86% of unmarried people ages 18 to 29 are sexually active. And though it may not be surprising that 87% of the same group reported that they are not ready to have kids — including 88% of women and 86% of men — their actions don't always line up with their intentions.

Among the group polled by the National Campaign, nearly half of those who are in a sexual relationship either don't use contraception at all or use it inconsistently, and almost 20% of all respondents predict that they'll have unprotected sex within the next three months.

The result? Seven in 10 pregnancies in the 18-to-29 age group are unintended, and men and women in their 20s have among the highest rates of sexually transmitted infections of any age group, including chlamydia, gonorrhea and syphilis.

"Teens get a lot of attention around childbearing and pregnancy," says Heather Boonstra, senior public policy associate at the Guttmacher Institute, a New York and Washington, D.C.-based research organization that focuses on sexual and reproductive health. "But the age group that has the most trouble, and the highest rates of unintended pregnancy and abortion, are those in their early 20s."

Lack of access to healthcare is part of the problem, says Boonstra, who authored "The Challenge in Helping Young Adults Better Manage Their Reproductive Lives," a report published in the Guttmacher Policy Review in 2009.

People in their 20s "are the group most likely not to have health insurance today," she says. According to the U.S. Census Bureau, approximately 27% of people ages 18 to 34 were uninsured in 2008, the highest of any age group. Without such coverage, contraception can cost anywhere from $10 to $70 per month for hormonal birth control such as the pill or the NuvaRing (that's excluding the cost of a doctor's visit to obtain such a prescription), and more than $700 up front for longer-term birth control such as an intrauterine device (IUD).

But most experts agree that young adults' difficulty in managing their reproductive health is significantly affected by factors that run much deeper than access to care.

To begin with, the National Campaign discovered a considerable discrepancy among those ages 18 to 29 between perceived understanding and actual understanding of how to prevent pregnancy. Of those polled, 90% reported that they know everything they need to know to avoid pregnancy, yet nearly 80% of men and 30% of women in the same group said that they know "little or nothing" about the birth control pill. And 24% of all respondents believe that wearing two condoms provides double protection, when in fact it increases the chance of breakage.

And though they grew up in the era of "Sex and the City" and Internet porn, talking with partners about safe sex is just as difficult for people in this age group as for any other.

Catherine Toyooka, a Silicon Valley-based sex educator and founder of Catherine Coaches, a dating and sexuality education company, sees this difficulty firsthand. "They want to do the right thing," she says of the young people who take her classes, "but it's not really the easiest thing to talk about. They don't have the skills."

Adds Boonstra, "It takes a certain practice or finesse to be comfortable talking with your partner about sex and the use of contraception or condoms."

Many young adults also have deep-rooted — and occasionally conflicting — feelings about becoming parents. Though they may not be ready for children at this point, many want kids someday, and 32% of those polled by the National Campaign said they'd be "very pleased" or "a little pleased" to find out that they or their partner were pregnant.

The percentage of men who reported that they would be pleased in the event of an unintended pregnancy was more than twice that of women.

But whatever the reasons behind it, no amount of magical thinking will negate the fact that ambivalence about safe sex can — and does — have lasting consequences.

Many common sexually transmitted infections can lead to serious health problems. Chlamydia, if left untreated, can cause infertility, and late-stage syphilis can be fatal.